Instructions for completing a statutory declaration

Please complete the following form using the notes in the left-hand margin for guidance. More guidance on
making statutory declarations can be found at www.justice.vic.gov.au.
When making the statutory declaration the declarant must say aloud:
I, [full name of person making declaration] of [address], declare that the contents of this statutory declaration are true
and correct.

Statutory Declaration

I,
Insert the name, address
and occupation (or
alternatively, unemployed
or retired or child) of
person making the
statutory declaration. make the following statutory declaration under the Oaths and Affirmations
Act 2018:

1.
Set out matter declared to
in numbered paragraphs.
Add numbers as necessary.

I declare that the contents of this statutory declaration are true and
correct and I make it knowing that making a statutory declaration that I
know to be untrue is an offence.

Signature of person
making the declaration
Declared at
Place (City, town or *in the state of Victoria
suburb)
on
Date
I am an authorised statutory declaration witness and I sign this document
Signature of authorised in the presence of the person making the declaration:
statutory declaration
witness

Date on

Name, capacity in which

authorised person has
authority to witness
statutory declaration, and A person authorised under section 30(2) of the Oaths and Affirmations Act
address (writing, typing or 2018 to witness the signing of a statutory declaration.
stamp)
 I certify that I read this statutory declaration to [name of the person making
The witness must only sign the statutory declaration] at the time the statutory declaration was made.
this section if the person
making the statutory
declaration is illiterate,
blind or cognitively
impaired and the statutory
declaration is read to
them.

This section must be I certify that I have assisted [name of the declarant] by [insert assistance
signed by any person who
provided, for example translating the document].
has assisted the person
making the statutory
declaration, for example Signed:
by translating the
document or reading it
aloud. If no assistance was
required, this section does
not need to be completed.
On:
Date

Name and address of

person providing
assistance Name and address of person providing assistance:
LIST OF AUTHORISED STATUTORY DECLARATION WITNESSES:

Under Section 19 of the Oaths and Affirmations Act 2018 (as of 1 March 2019),
previously Evidence (Miscellaneous Provisions) Act 1958, the list of persons who
may witness statutory declarations includes:

• A person currently licensed or registered to practice in Australia as one of the

following occupations:

o Architect

o Chiropractor

o Conveyancer

o Dentist

o Financial adviser or financial planner

o Legal practitioner

o Medical practitioner

o Midwife

o Migration agent

o Nurse

o Occupational therapist

o Optometrist

o Patent attorney

o Pharmacist

o Physiotherapist

o Psychologist

o Trade marks attorney

o Veterinary surgeon

• An accountant who meets at least one of the following criteria:

o Fellow of the National Tax Accountants’ Association

o Member of Chartered Accountants Australia and New Zealand

o Member of the Association of Taxation and Management Accountants

 o Member of CPA Australia

o Member of the Institute of Public Accountants

• Agent of the Australian Postal Corporation who is in charge of an office

supplying postal services to the public

• Australian Public Service employee engaged on an ongoing basis with 5 or

more years of continuous service who is not otherwise authorised

• Australian Consular Officer or Australian Diplomatic Officer

• Bailiff

• Bank officer with 5 or more continuous years of service

• Building society officer with 5 or more years of continuous service

• Chief executive officer of a Commonwealth court

• Clerk of a court

• Commissioner for Affidavits

• Commissioner for Declarations

• Credit union officer with 5 or more years of continuous service

• Employee of a Commonwealth authority engaged on a permanent basis with

5 or more years of continuous service who is not otherwise authorised

• Employee of the Australian Trade and Investment Commission who is

authorised in writing by the Secretary of DFAT to collect fees under s 3(d) of
the Consular Fees Act 1955, if at a place outside Australia and in the course
of the employee’s duties at that place

• Employee of the Commonwealth who is authorised in writing by the Secretary

of DFAT to collect fees under s 3(c) of the Consular Fees Act 1955, if at a
place outside Australia and in the course of the employee’s duties at that
place

• An engineer who meets at least one of the following criteria:

o A member of Engineers Australia, other than a student

o A Registered Professional Engineer of Professionals Australia

o Registered as an engineer under a law of the Commonwealth or a

State or Territory

o Registered on the National Engineering Register by Engineers

Australia
• Finance company officer with 5 or more years of continuous service

• Holder of a Commonwealth statutory office not otherwise specified

o For example, Director of the Australian Institute of Family Studies

• IBAC Officers

• Judge

• Justice of the Peace

• Local government Councillor

• Magistrate

• Registered marriage celebrant

• Master of a court

• Member of the Australian Defence Force who meets at least one of the
following criteria:

o An officer

o A non-commissioned officer with 5 or more years of continuous service

o A warrant officer

• Member of the Australasian Institute of Mining and Metallurgy

• Member of the Governance Institute of Australia Ltd

• Member of the Parliament of a State

• Member of a Territory legislature

• Member of a local government authority

• Registered minister of religion

• Notary public, including a notary public exercising functions at a place outside

either the Commonwealth or the external Territories of the Commonwealth

• Permanent employee of the Australian Postal Corporation with 5 or more

years continuous service who is employed in an office providing postal
services to the public

• Permanent employee with 5 or more years of continuous service who is not

otherwise specified, if employed at one of the following:

o State

o Territory
 o State authority

o Territory authority

o Local government authority

• Police officer

• Police reservist

• Protective service officer (PSO)

• Registrar, or Deputy Registrar, of a court

• A school principal

• Senior executive employee of a Commonwealth authority

• Senior executive employee of a State or Territory

• Senior Executive Service employee of the Commonwealth

• Sheriff

• Sheriff’s officer

• State Trustees officer or employee with a classification level of 2 or above

• Teacher employed on a permanent full-time or part-time basis at a school or

tertiary education institution

• Transport Accident Commission officer or employee with a classification of

level 2 or above

• VicRoads officer or employee with a classification of level 2 or above

• Victorian Inspectorate Officer

• A Victorian Public Service employee with a prescribed classification level of 2

or above

o For example, a project officer employed as a VPS4 or an

administrative assistant employed as a VPS2

• Victorian WorkCover Authority officer or employee with a classification of

band 2 or above

• Any authorised affidavit taker, including:

o A judicial officer

▪ For example, a judge or magistrate

o An associate to a judicial officer

o An honorary justice

o The prothonotary or a deputy prothonotary of the Supreme Court

o The registrar of probates or an assistant registrar of probates

o The registrar or a deputy registrar of the County Court

o The principal registrar, a registrar or a deputy registrar of the

Magistrates’ Court

o The principal registrar, a registrar or a deputy registrar of the Children’s

Court

o The principal registrar, a registrar or a deputy registrar of VCAT

o The principal registrar or a registrar of the Coroners Court

o A member of VCAT

o A member or former member of either House of the Parliament of

Victoria

o A member or former member of either House of the Parliament of the

Commonwealth

o A public notary

o A senior officer of a Victorian municipal Council who meets one of the

following criteria:

▪ Chief Executive Officer

▪ A member of Council staff with management responsibilities and

reporting directly to the Chief Executive Officer

▪ Any other member of Council staff earning a salary of at least

$124,000 (or a higher threshold, if specified by the Minister
under s 97B of the Local Government Act 1989)

o A fellow of the Institute of Legal Executives (Victoria)

o A person acting judicially

▪ For example, an arbitrator or any person or body with authority

to hear, receive and examine evidence

o Any other officer or person empowered, authorised or permitted by or

under any Act or rules of a court or rules of a tribunal to administer
affidavits